Factors Associated with Pregnancy Stress in High-Risk Pregnant Women Before Invasive Prenatal Diagnosis: A Cross-Sectional Study

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Purpose: Pregnant women often experience pregnancy stress, which negatively impacts maternal and fetal health. Studies on pregnancy stress in high-risk pregnancies are limited. This study aimed to investigate pregnancy stress in high-risk pregnant women before invasive prenatal diagnosis and analyze factors associated with pregnancy stress. Materials and Methods: This single-center, cross-sectional study, conducted from September 2023 to May 2024 at a medical institution in Jiangsu Province, China, included 509 high-risk pregnant women. Convenience sampling was used to recruit participants. Self-administered questionnaires were used to collect socio-demographic characteristics, clinical characteristics, pregnancy stress, doctor-patient communication, and family function. Pregnancy stress was assessed using the Pregnancy Stress Rating Scale (PSRS). Multiple linear regression identified factors associated with pregnancy stress. Results: Among the participants, 363 (71.3%) had mild stress, and 53 (10.4%) had moderate to high stress. Among the three dimensions of PSRS, worrying about the health and safety of the mother and child had the highest score. Multiple linear regression analysis showed that factors associated with pregnancy stress in high-risk women included knowledge of prenatal genetic testing ( B = 0.108, 95% CI : 0.030– 0.186, P < 0.01), reproductive history ( B = 0.116, 95% CI : 0.047– 0.186, P < 0.01), pregnancy symptoms ( B = − 0.111, 95% CI : − 0.217 - − 0.004, P < 0.05), nutritional status ( B = 0.079, 95% CI : 0.007– 0.151, P < 0.05), perceived poor resistance ( B = 0.179, 95% CI : 0.056– 0.302, P < 0.01), doctor-patient communication ( B = − 0.014, 95% CI : − 0.028 - − 0.001, P < 0.05), and family function ( B = − 0.045, 95% CI : − 0.063 - − 0.027, P < 0.001). Conclusion: Doctor-patient communication, family function, and some clinical characteristics was associated with pregnancy stress in high-risk pregnant women. Therefore, future interventions should enhance family support and improve doctor-patient communication. Keywords: pregnancy stress, high-risk pregnant women, invasive prenatal diagnosis, associated factors, China

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